美金刚联合经颅磁刺激在卒中后失语症患者中的应用效果评价  

Evaluation of the effect of memantine combined with transcranial magnetic stimulation in patients with post-stroke aphasia

作　　者：辛茹 芮冉 朱呈伟 Xin Ru;Rui Ran;Zhu Chengwei(Nanshi Hospital of Nanyang,Nanyang 473000,Henan,China)

机构地区：[1]南阳南石医院,河南南阳473000

出　　处：《临床心身疾病杂志》2024年第6期15-19,56,共6页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨美金刚联合经颅磁刺激(TMS)对卒中后失语症(PSA)患者临床疗效、负性情绪、氧化应激反应的影响。方法将100例PSA患者以抽签法分为2组,每组50例。对照组患者给予美金刚治疗,观察组患者在对照组基础上联合TMS治疗。治疗前后比较两组患者的言语功能[西方失语症成套测试(WAB)评分]、负性情绪[汉密顿焦虑量表(HAMA)及汉密顿抑郁量表(HAMD)评分]、事件相关电位潜伏期、P300波幅、颅内血流动力学指标、氧化应激反应指标[谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)水平]及生活质量[脑卒中失语症生活质量量表(SAQOL-39)]评分。结果治疗后,两组患者WAB各维度评分均高于治疗前,且观察组高于对照组(P<0.01)。治疗后,两组患者HAMA及HAMD评分均低于治疗前,且观察组低于对照组(P<0.01)。治疗后,两组患者N2、P300潜伏期均长于治疗前,观察组患者P300波幅低于治疗前,且观察组各指标均优于对照组(P<0.05或0.01)。治疗后,两组脑前动脉、中动脉和后动脉流速均高于治疗前,且观察组高于对照组(P<0.01)。治疗后,两组患者GSH-Px、SOD水平均高于治疗前,且观察组高于对照组(P<0.01)。治疗后,两组患者SAQOL-39各维度评分均高于治疗前,且观察组高于对照组(P<0.01)。结论美金刚联合TMS可显著改善PSA患者的负性情绪、言语功能和生活质量,并有效缓解其氧化应激反应,临床疗效显著,值得推广。Objective To explore the influence of memantine combined with transcranial magnetic stimulation(TMS)on clinical effects,negative emotions and oxidative stress responses(OSR)in patients with post-stroke aphasia(PSA).Methods A total of 100 PSA patients were divided into two groups according to drawing lots,with 50 ones in each.Controls were treated with memantine and observation group was plus the TMS on the basis of controls.Before and after treatment such indexes were compared between two groups as speech function(Western Aphasia Battery[WAB]scores),negative emotions(Hamilton Anxiety Scale[HAMA]and Hamilton Depression Scale[HAMD]scores),event-related potentials(ERP)latency,P300 amplitude,intracranial hemodynamics indictors,OSR indicators(glutathione peroxidase[GSH-Px]and superoxide dismutase[SOD]levels),and scores on the quality of life(Stroke and Aphasia Quality of Life Scale-39[SAQOL-39]).Results After treatment each dimension scores of the WAB in both groups were higher compared with pre-treatment and so were those in observation than control group(P<0.01).After treatment scores on the HAMA and HAMD in both groups were lower compared with pre-treatment and so were those in observation than control group(P<0.01).After treatment,N2 and P300 latency were longer and P300 amplitudes was lower in both groups compared with pre-treatment,and observation group were better than controls(P<0.05 or 0.01).After treatment anterior,posterior and middle cerebral artery flow velocity elevated in both groups compared with pre-treatment and those were higher in observation than cont rol group(P<0.01).After treatment GSH-Px and SOD levels in both groups were higher compared with pre-treatment and so were those in observation than control group(P<0.01).After treatment each dimension scores of the SAQOL-39 in both groups were higher compared with pre-treatment and so were those in observation than control group(P<0.01).Conclusion Megaman combined with the TMS can significantly improve negative emotions,language function and quality

关 键 词：卒中后失语症 美金刚 经颅磁刺激 临床疗效 负性情绪 氧化应激反应 

分 类 号：R743.3[医药卫生—神经病学与精神病学]